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Patrick Neustatter's op-ed column in rebuttal of Del. William Howell on Medicaid.
I DISAGREE WITH many of the points Speaker of the House of Delegates William Howell makes in his Viewpoints column, "Responsible alternatives must be found to expanding Medicaid," in The Free Lance-Star on Jan. 5. But there is one fundamental point where he's really got it wrong.
Medicaid should be run "based on the principles utilized in the private market" because "these principles keep costs down and improve the quality of care," he tells us.
There are innumerable reports and statistics I could quote demonstrating that the "free market" philosophy of U.S. health care does not provide good-value, high-quality health care: The U.S. spends about twice as much per capita as other industrialized nations ($8,233 in the U.S. versus $3,433 in the U.K. for 2010, for example), and was ranked 46th out of 48 nations for quality/efficiency in a recent Bloomberg study.
Medicines cost at least twice as much in the U.S., and many seniors, especially, are unable to afford them. The pharmaceutical industry makes twice the profits of the average Fortune 500 company. When former Sen. Byron Dorgan, D-N.D., was trying to get Congress to allow "free market" competition to those drug companies by allowing the importation of medicines, he noted that Nexium cost $40 in the United Kingdom, and $424 in the U.S. But that was unsuccessful, as have been attempts to allow Medicare to negotiate drug prices.
But that's the problem. "Private market" is all well and good with a level playing field.
But it's not.
There are innumerable fandangles the health care industry has managed to persuade Congress to go along with, affecting far more than just drug prices.
It's hard to ignore the desires of an industry that has almost limitless funds and spends more than twice as much on lobbying as aerospace and defense, and oil and gas combined.
Bill Howell is a smart guy, and I'm sure a sincere believer in the free market versus the idea of government running our lives--the two fundamental philosophies being duked out in the health care debate.
But the private market doesn't have our welfare at heart. Their profits is what matters to them--by whatever means.
In other countries, what people in the U.S. so often characterize as evil "Big Government" sets limits on drug prices, and does much else to ensure quality and value for money.
I think it's a myth that private market principles will do that in the U.S.
Patrick Neustatter, M.D. is medical director of the Lloyd Moss Free Clinic.